Learning to Swim in The Alphabet Soup of the DSM

Tag Archives: Abilify and sexual development

This might be an odd topic to discuss, but it’s actually very important in terms of adolescent mental health particularly if there is a biologically-based brain disorder on the table.

What happens when puberty strikes?

Let me get this off my chest. I hate the word ‘puberty’. I don’t know why. It’s a weird word, isn’t it? I don’t even like to say it aloud. “Puuuuuuuuuberty.” No. Just…no.

What else can I call it? Game Day? The Dawn of a New Age? Rites of Passage? Pledge Week? These all sound like terrible movies, cults, or something that happens to you at a Greek Week event. But, isn’t that what puberty feels like? I digress…

Everyone warned me that puberty would be an über nightmare for Grace as opposed to the standard nightmare that the neurotypical folks experience because the sudden surge in hormones might possibly increase the intensity of her diagnosis–schizophrenia spectrum disorder. I winced. It is a valid concern because onset of puberty is often the time when schizophrenia and bipolar spectrum disorders emerge. If you have a child who has a childhood-onset diagnosis, then what might puberty change or exacerbate?

So, how has it been?

Well, the first thing to note here is that Grace has been taking Abilify since she was 11 years-old, and Abilify affected her sexual development. She didn’t experience any signs of puberty until she was well into her 15th year. That’s late. It was concerning. We were almost referred to an endocrinologist.

The second thing to note is that her symptoms were in no way exacerbated by her diagnosis. She was a very typical teenager if ‘typical’ is a thing. In other words, her behavior and thoughts were well within the bell curve for what I would define as normative although she has favored emo-angsty self-expression for about a year. It’s like living with a character from a knock-off John Hughes movie. The month prior to menarche (another word that should never be used), however, she became an asshole, and no one knew why.

Also, she wanted to snort and mainline sugar. I had to practically build a wall between her and the kitchen just to keep her away from anything potentially sugary–even granulated sugar! She hated everything as well. She was rude. She wanted to be left alone. Everything was bad. And, she cried all the time. She is my third daughter. I’ve seen all this before but not quite at this level. A friend commented, “Wow, she just hates everything.”

Well, when her first period arrived, it all crystallized, and her mood cleared up. It’s damn hard being a girl.

We did not, however, have any psychotic symptoms. We did not have a surge in mania. It was fairly typical. Everyone in the house gets a bit moody and upset as their hormones ebb and flow. Doireann cries. Eadaoin gets punchy. Grace hates everyone and everything. I feel irritable. It is life. You learn to go with the flow (sorry about the pun…).

The good news? There was no apocalypse, and that means a lot because more than a few people prognosticated the end of the world for Grace when Shark Week hit.

So, should you be in a similar situation, wondering how your child will do when the surge of hormones bathes their brain in all the colors of the moody, developmental rainbow, have hope. Sometimes things go smoothly and everything works out.